Type-2 inflammation mediates olfactory loss in Chronic Rhinosinusitis: mechanisms and therapeutic opportunities

项目摘要 这是向NIH申请布鲁斯K的研究者发起的研究项目资助（R 01）的申请。谭博士， 西北大学耳鼻喉科助理教授。 人类的嗅觉对于刺激食欲，指导食物选择，避免变质食物至关重要。 和有毒化学物质，并提高整体生活质量。不幸的是，许多慢性病患者 鼻窦炎（CRS）遭受长期的嗅觉丧失，尽管药物和手术治疗。我们 进一步发现2型鼻粘膜炎症患者更频繁和严重， 鼻窦手术前后嗅觉丧失的影响。2型炎症的CRS患者也更多 他们的症状可能会复发，需要反复手术。主要研究者是 外科医生兼科学家，临床兴趣集中在CRS患者，但已完成广泛的指导 粘膜免疫训练这项提议旨在将我们实验室最近的一项新发现转化为现实， 发现气道上皮细胞对IL-4和IL-13的反应，关键的2型细胞因子引起最严重的 慢性鼻窦炎的形式，需要称为非胃H+/K+ ATP酶的离子泵的作用。具体 实验将：（1）评估非胃H+/K+ ATP酶引起气道炎症的机制 使用药物抑制剂和基因敲除细胞系治疗炎症;（2）评估如何使用嗅觉丧失来 准确识别鼻窦手术后活动性2型炎症患者;（3）进行临床研究 找出如何有效地使用质子泵抑制剂，以减少气道嗜酸性粒细胞炎症和测试 它们是否可以减少CRS患者的2型炎症并改善嗅觉功能。如果成功， 这些研究将坚定地建立一种新的机制， 条件此外，这项研究的结果可能会发现创伤性较小的方法来识别2型 鼻气道炎症。最后，临床研究可能会发现治疗持续性2型糖尿病的新药。 鼻窦手术后患者的炎症和嗅觉丧失-目前没有有效的治疗方法 医学治疗

Project Summary This is a request to the NIH for an Investigator-Initiated Research Project Grant (R01) for Bruce K. Tan, MD, MS, Assistant Professor of Otolaryngology at Northwestern University. The sense of smell in humans is pivotal for stimulating appetite, guiding food selection, avoiding spoiled foods and noxious chemicals, and enhancing overall quality of life. Unfortunately, many patients with chronic rhinosinusitis (CRS) suffer from extended periods of smell loss despite medical and surgical treatment. We further find that patients with type 2 inflammation of the nasal mucosa are more frequently and severely affected by smell loss before and after sinus surgery. CRS patients with type 2 inflammation are also more likely to experience recurrence of their symptoms and require repeated surgery. The Principal Investigator is a surgeon-scientist whose clinical interests focus on CRS patients but has completed extensive mentored training in mucosal immunity. This proposal seeks to translate a recent novel discovery in our laboratory that found that airway epithelial cell responses to IL-4 and -13, critical type 2 cytokines causing the most severe forms of chronic sinusitis, require action of an ion pump called the non-gastric H+/K+ATPase. Specific experiments will: (1) evaluate mechanisms by which the non-gastric H+/K+ATPase causes airway inflammation using drug inhibitors and genetic knockout cell lines; (2) evaluate how to use smell loss to accurately identify patients with active type 2 inflammation after sinus surgery; and (3) perform clinical studies to find out how to effectively use proton pump inhibitors to reduce airway eosinophilic inflammation and test whether they can reduce type 2 inflammation and improve smell function in patients with CRS. If successful, these studies will firmly establish a novel mechanism that disrupts the airway barrier in type 2 inflammatory conditions. Additionally, the results of this study may identify less invasive methods to identify type 2 inflammation in the nasal airway. Finally, the clinical studies may discover new drugs to treat persistent type 2 inflammation and smell loss in patients after sinus surgery- problems for which there are currently no effective medical treatments.